A 'Heart-felt' Plea...

Hi again everyone,

This health blog summarizes one of my many pet peeves in health and wellness ... i.e: How easy it is send the world's number one serial killer "Atherosclerosis" to jail for life!  The stats are scary: Each year, atherosclerosis and its downstream effects prematurely kills ~70% of people on the planet.  And to prevent it?  Just get a blood test!  So ... why not learn the following and do the following?

1. Atherosclerosis literally means 'hardening of the arteries' because of the deposition of a hard, inflexible plaque-like substance called an atheroma.  This atheroma is composed of cholesterol and fats, as well as calcium, bicarbonate, and blood clot materials. It has the consistency of plaque on our teeth which is so hard that we can't brush it away.  The dentist must scrape it off manually (getting my cleaning done today! ... smile).  But, no "cardio-dental scraping device" exists, so, unless we are willing to undergo dangerous surgery to install a 'stent', we must understand how to prevent the atherosclerotic plaque from forming in the first place ...

2. Our arteries are meant to dilate and constrict automatically to provide vital blood to various parts of our bodies with the right amount of blood flow when needed.

3. This amazing process is called "Autoregulation".  Think of what happens to your face when you blush!  Your many smiling muscles are contracting, creating an immediate need for energy (from blood-born glucose and oxygen).  So, the tiny arteries in your face dilate (expand) and your capillaries become engorged with life-giving blood.  And the opposite is true during hypothermia, eg. constriction of blood vessels in the face/skin during the winter.

4. So, autoregulation helps our bodies maintain both blood flow and blood pressure.  No wonder alterations in this important process can lead to diseases like cell death (from a localized lack of nutrients) and high blood pressure (hypertension).  And here is where atherosclerosis rears its ugly head.

5. The bad news?  Atheromas grow within the lining of our blood vessels so that our blood does not have direct access to it to 'flush/brush' the deposits away.  Think of a 'pimple' slowly growing within the layers of the arteries.  The larger the plaque, the harder it is for the blood vessel to dilate and contract, and smaller the space through which blood flows.  Think of your finger slowly closing over the opening of a water hose.  Doesn't the water pressure gradually increase so you could spray water further?  The physics is simple: The smaller the diameter of a tube, the greater the resistance to flow, leading the an increase in pressure. In the same way, plaque-laden blood vessels cause an increase in blood pressure.  Since our circulatory system is a "closed hose system", pressurized blood cannot escape through an opening (thank goodness...that's called 'bleeding to death').  The result is chronic hypertension which can lead to a myriad of malfunctions like bursting, 'leaky' vessels, leading to chronic edema (swelling) and so on.

6. Fortunately, or unfortunately, depending on whether we get our blood tested in time, our amazing bodies adapt to the presence of these plaques (autoregulation, remember?) such that atherosclerosis is often called "The Silent Killer".  In fact, a blood vessel must be 60-70% blocked for us to even feel the effects of the plaque buildup.  But, once the plaque size goes past the 70% point of no return, our bodies can no longer respond and, just like a pimple, the growing plaque can burst, causing a wound within the blood vessel, leading to a blood clot (thrombus), which now blocks blood flow altogether. If this happens in blood vessels serving the heart (the coronaries) ... result = A Heart Attack (Myocardial Infarction, MI).  If vessels serving the brain are blocked ... A Stroke.  In the arms/legs?  Peripheral Artery Disease (P.A.D. or Restless Leg Syndrome).  And, if pieces of the clot breaks off and travels to other parts of the body (eg. lungs) ... Embolism.  That is, atherosclerosis is an underlying cause of the most common, deadliest diseases on the planet, bar none ... aka The Cardiovascular Diseases.

7. The GOOD -*no*- GREAT news!?  This 'pimple' takes ~40 years to grow! Imagine what would happen if atheromas were to develop in your arteries as fast as a pimple in your skin (am I the only one who has gone to bed with smooth, clear skin and woken up the next morning with a huge pimple like a second head, staring back at me in the mirror?)  So, we have 40 years to get our blood cholesterol (ie: ratio of bad LDLs to good HDLs), blood fats (triglycerides), and blood pressure checked!  If hypercholesterolemia (high cholesterol levels in the blood) is found, there are a vast array of things we could do!  From improving of diet (eg. less cholesterol and (trans/saturated) fats; more phytosterols), to expanding our exercise regimen (only 30 min a day, 3 days a week according to the World Health Organization, WHO) to checking our family history (DNA) via genetic counseling, to using statin drugs (Lipitor, Zocor, Crestor...) to halt and reduce the rate of buildup of plaque!

8. And get this...right now, in a pharma lab somewhere tests are being done to prove that statins plus phytosterols (natural plant-derived cholesterols that do what cholesterol can do (emulsify fats) without causing plaques) leads to a reduction plaques by greater than 20%!  Hmmm...from 70% blockage down to 50% or less?  That's at least 10 years more life right there!  Talk about great news!  And these plant sterols are now everywhere! ... From yogurts, to cereals, to certain juices and chocolates, to Bayer's one-a-day aspirin!

Folks, let's work hard to get that *darn* stat down from 70% mortality for cardiovascular diseases to, well, much less than 70%!...Let's put this serial killer behind bars and keep ourselves and our loved ones around for longer...And it all starts with a simple blood test!

See www.heartandstroke.ca, click the Google Ads on this blog, and see your cardiologist to learn more!

Thanks for reading,

Dr. Sheldon

 

Dyslipidemia and Atherosclerosis Essentials 2009Journal of Atherosclerosis and ThrombosisUnclog Your Arteries : How I Beat AtherosclerosisTranseophageal Echo Aorta with Heavy Atherosclerosis Photographic Poster Print, 12x16Biochemistry of Atherosclerosis (Advances in Biochemistry in Health and Disease)Women, Stroke and the Red Dress: Cerebrovascular Disease in WomenMolecular Mechanisms of AtherosclerosisDomyaku Koka = Journal of Japan Atherosclerosis SocietyAtherosclerosis: Molecular and Cellular MechanismsAtlas of Atherosclerosis : Risk Factors and TreatmentBiology Concepts: Cardiovascular DiseaseArtery Model Progressive Set Cholesterol AtherosclerosisAtlas of Atherosclerosis Progression and Regression, Second Edition (Encyclopedia of Visual Medicine Series)The Nutritional Bypass : Reverse Atherosclerosis Without SurgeryCardiac Stress Test: Medical test, Artery, Blood flow, Heart, Physical exercise, Mount Sinai Hospital, New York, Atheroma, Atherosclerosis, Cardiac arrhythmia, ... Cardiology diagnostic tests and proceduresAtherosclerosis and Heart DiseaseAtherosclerosis: Pathology of the Vasculature in Live PatientsReversing Atherosclerosis (American lecture series ; publication no. 1031)Atherosclerosis Medical GuideAtherosclerosis: Diet and Drugs (Handbook of Experimental Pharmacology) (Volume 170)

How do you solve a problem like Malaria?

The Sound of Music Stage Performance is about to close here in Toronto, so today's blog title is in honour of them!  It was a great show ... 'twill be missed ... but I digress ...

1. Malaria is caused by single-celled, nucleated protists (not bacteria), genus Plasmodium, that first target our red blood cells then our livers.

2. These protists are carried from one human body to another via mosquitoes, hence these insects are called 'vectors' for malaria.

3. Interestingly, only female mosquitoes bite humans and their saliva contains anti-coagulants so that our blood does not clot while they are feasting on us ... that's why we end up with redness at the site of a bite.

4. Like all infectious diseases, to stop the spread of the disease one must either become Immune to it, or The Cycle of Infection must be broken.

5. Immunity to malaria can happen in two ways: 1. Via an effective vaccine (not yet in existence) or 2. By being born with the Sickle Cell Trait.

6. Since malaria is endemic (always around) in certain African countries, the disease acts as a 'natural selection pressure' for the sickle cell trait there.

7. That is, persons born with a certain percentage of their red blood in a mutant sickle shape (a sickle is the C-shaped machete used to harvest wheat in Russia, for example) are less likely to be seriously affected or killed by malaria because Plasmodium cannot invade sickled cells.  So, persons with the trait live longer to make more malaria-resistant offspring.  No wonder the 'favourable' sickle cell trait still exists in many people of African descendent!

8. No vaccine?  You don't have the sickle cell trait?  Then ... just break the cycle of infection: 1. Use mosquito nets; 2. Use mosquito repellents; 3. Clear away any pools of standing water (breeding grounds for mosquito larvae); 4. Zap the bugs out of the air with a laser (yup ... courtesy of the NASA scientists who invented the Star Wars Laser Satellite Program ... look it up!)

Till next time and remember: Feel free to ask me anything on health and wellness and I will endeavour to answer in my blogs.  Look out for my upcoming Christmas/New Year health and wellness blogs.  In the meantime, for more information, feel free to click on the Google Ads associated with this blog and see www.mosquitocontrol.ca. 

Thanks for reading,

Dr. Sheldon

The Making of a Tropical Disease: A Short History of Malaria (Johns Hopkins Biographies of Disease)The Malaria Capers : More Tales of Parasites and People, Research and RealityMalaria: Fever WarsHumanity's Burden: A Global History of Malaria (Studies in Environment and History)GIANT Microbes - Malaria (Plasmodium falciparum) Plush ToyParasites! - The Malaria ParasiteMolecular Approaches to MalariaQuinine: Malaria and the Quest for a Cure That Changed the WorldThe Elusive Malaria Vaccine: Miracle or Mirage?Malaria - a Handbook for Health ProfessionalsMalaria Protection KitMalaria: Poverty, Race, and Public Health in the United States